Breathing Workout Is As Effective In Lowering Blood Pressure As Drugs

Working out for five minutes everyday using a technique dubbed “strength training for your breathing muscles” lowers blood pressure and improves several indicators of vascular health as effectively as, if not more effectively than, aerobic exercise or medication, new CU Boulder research reveals.

The study, which was published in the Journal of the American Heart Association on June 29, provides the strongest evidence yet that the ultra-time-efficient maneuver known as High-Resistance Inspiratory Muscle Strength Training (IMST) may play a critical role in helping older adults avoid cardiovascular disease, the nation’s leading killer.

In the United States alone, 65 percent of persons over the age of 50 have hypertension, increasing their risk of heart attack or stroke. Nonetheless, less than 40% adhere to prescribed aerobic exercise requirements.

“There are numerous lifestyle practices that we are aware of that can assist individuals in maintaining cardiovascular health as they age. However, the reality is that they require some time and effort and can be prohibitively expensive and difficult to obtain for some people “Daniel Craighead, the study’s lead author and an assistant research professor in the Department of Integrative Physiology, explained. “IMST can be completed in five minutes while watching television in your own home.”

IMST was developed in the 1980s to assist critically ill patients with respiratory disorders in strengthening their diaphragm and other inspiratory (breathing) muscles. It entails vigorously inhaling via a hand-held device that creates resistance. Consider sucking vigorously through a tube that also sucks back.

Initially, doctors recommended a 30-minute-per-day routine at low resistance when recommending it for breathing issues. Craighead and colleagues have been investigating whether a more time-efficient strategy — 30 inhalations per day at high resistance, six days a week — could also result in benefits in cardiovascular, cognitive, and athletic performance.

They enrolled 36 otherwise healthy adults aged 50 to 79 with elevated systolic blood pressure for the new trial (120 millimeters of mercury or higher). Half received high-resistance IMST for six weeks, whereas the other half received a placebo treatment with significantly less resistance.

After six weeks, the IMST group observed an average drop of nine points in their systolic blood pressure (the top number), a reduction that generally exceeds that achieved by walking 30 minutes five days a week. This decrease is also comparable to the effect of certain blood pressure-lowering medication regimens.

Six weeks after discontinuing IMST, the IMST group retained the majority of their improvement.

“We discovered that it is not only more time efficient than standard workout routines, but that the advantages may be longer lasting as well,” Craighead explained.

Additionally, the therapy group experienced a 45 percent increase in vascular endothelial function, or the ability of arteries to expand in response to stimulation, as well as a large increase in nitric oxide levels, a chemical critical for dilating arteries and avoiding plaque accumulation. Natural declines in nitric oxide levels occur as people age.

Inflammatory and oxidative stress markers, which can further increase the risk of heart attack, were dramatically reduced after participants completed IMST.

Additionally, the IMST group completed 95% of the sessions.

“We have uncovered a unique method of lowering blood pressure without administering pharmaceutical agents and with significantly higher adherence than aerobic exercise,” said senior author Doug Seals, a Distinguished Professor of Integrative Physiology. “That is notable.”

This technique may be especially beneficial for postmenopausal women.

Seals’ laboratory previously demonstrated that postmenopausal women who do not take supplementary estrogen do not benefit as much from aerobic exercise programs as men do in terms of vascular endothelial function. The latest study found that IMST improved it equally as much in these women as it did in men.

“If aerobic exercise alone is not sufficient to enhance this critical marker of cardiovascular health in postmenopausal women, they require another lifestyle intervention,” Craighead explained. “Perhaps this is it.”

MST may also improve several markers of brain function and physical fitness, according to preliminary findings. Additionally, recent study from other experts has demonstrated that it can be beneficial for increasing athletic performance.

“When you run a marathon, your respiratory muscles become fatigued and begin stealing blood from your skeletal muscles,” explained Craighead, who trains for marathons with IMST. “The idea is that by increasing the endurance of those respiratory muscles, this will prevent this from happening and your legs will not become as weary.”

Seals said they are unsure how a maneuver to strengthen breathing muscles results in blood pressure reduction, but they assume it stimulates the cells lining blood arteries to create more nitric oxide, allowing them to relax.

Seals was recently awarded $4 million by the National Institutes of Health to do a larger follow-up study with approximately 100 patients, comparing a 12-week IMST protocol against an aerobic exercise program.

Meanwhile, the study team is working on a smartphone application that would enable users to perform the protocol at home using commercially accessible hardware.

Individuals considering IMST should consult their physician first. However, they stated that IMST has been incredibly safe thus far.

“It’s simple to perform, it’s quick, and we believe it has a lot of potential to benefit a lot of people,” Craighead explained.

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Materials provided by University of Colorado at Boulder


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